Healthcare Provider Details

I. General information

NPI: 1629170873
Provider Name (Legal Business Name): LAURA KAY HARDIN-LEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 05/27/2023
Certification Date: 05/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10211 ALM ST STE 1200
RALEIGH NC
27617-8221
US

IV. Provider business mailing address

10211 ALM ST STE 1200
RALEIGH NC
27617-8221
US

V. Phone/Fax

Practice location:
  • Phone: 919-206-4889
  • Fax: 919-206-4875
Mailing address:
  • Phone: 919-206-4889
  • Fax: 919-206-4875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9700070
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: